Abstract
OCT (optical coherence tomography) is widely used in ophthalmology and pediatric ophthalmology, but limited research has been done on the use of OCT in strabismus. This study investigates the use of different OCT machines to image rectus muscle insertions pre-, intra-, and post-operatively in pediatric strabismus patients. The OCT machines used in the study were a Bioptigen (Leica Microsystems Inc., Buffalo Grove, IL, USA), Spectralis HRA+OCT with Anterior Segment Module (Heidelberg Engineering, Heidelberg, Germany), Visante (Carl Zeiss, Oberkochen, Germany), and Zeiss Rescan 700 (Carl Zeiss, Oberkochen, Germany). Measurements from the machines were compared with the caliper distance measured during the strabismus surgery before disinsertion or after reattachment. The OCT machines had moderate (Bioptigen: 0.62) to good intraclass correlation coefficients (Rescan: 0.83, Spectralis: 0.85, Visante: 0.88) with intra-operative measurements. To our knowledge, this is the first study to use an operating microscope with integrated intra-operative OCT to image rectus muscle insertions. OCT is a useful tool in strabismus surgical patients in the pre-, intra-, and post-operative settings, particularly in patients who have had previous surgery, when the muscle insertion is unknown. The ability to accurately image rectus muscle insertions has significant implications for the management of strabismus patients.
Highlights
Strabismus surgery on patients with previous strabismus, orbital, or other ophthalmic surgeries can be challenging, and the response to surgery less predictable than in patients without prior ocular surgery
Knowing the location of the extraocular muscles (EOMs) prior to surgery and what previous surgery was performed can be very beneficial to the surgeon
The results show that many different optical coherence tomography (OCT) machines that are available are capable of imaging rectus muscle insertions
Summary
Strabismus surgery on patients with previous strabismus, orbital, or other ophthalmic surgeries can be challenging, and the response to surgery less predictable than in patients without prior ocular surgery. Even with the previous operative reports or a history from the patient, the location of the extraocular muscles (EOMs) can be different than expected. Knowing the location of the EOMs prior to surgery and what previous surgery was performed can be very beneficial to the surgeon. Several techniques have been used to image the EOM pre-, intra-, and post-operatively to help plan surgery and reduce surgical exploration and time, including computed tomography (CT), magnetic resonance imaging (MRI), B-Scan ultrasonography (US), and ultrasound biomicroscopy (UBM) [2–11]. More recent studies have used the optical coherence tomography (OCT) to image EOM insertion on un-operated-on and previously operated-on muscles, but to our knowledge, none have used an operating microscope with integrated intra-operative OCT [12–29]
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